<section class="container-fluid">
  <div class="row">
    <div class="demand-wrapper">
      <h3 class="title">
        马上提交需求，我们会在24小时内联系您，并提供产品咨询和项目报价！
      </h3>
      <a class="ui-btn" data-toggle="modal" data-target="#myModal">
        立即提交需求
      </a>
    </div>
  </div>
</section>

<!-- Modal -->
<div class="modal fade" id="myModal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
  <div class="modal-dialog" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
        <h4 class="modal-title" id="myModalLabel">
          联系我们
        </h4>
      </div>
      <div class="modal-body">
        <form id="w0" class="right_form form-horizontal" action="/message/index.html" method="post">
          <input type="hidden" name="_csrf" value="RUQrNCbd3C5GtnEdYWL7JXf7yDwyG2Bqejt-5BE02N4vEV16Y5y6fgTYLi4QGotVT7qaS3pJIgEPQkymRlCtkg==">
          
          <div class="form-group">
            <label for="message-truename" class="col-sm-2 control-label">
              <span class="red">*</span>
              真实姓名
            </label>
            <div class="col-sm-10">
              <input type="text" class="form-control" id="message-truename" name="Message[truename]" placeholder="请填写您的姓名或单位名称">
            </div>
          </div>

          <div class="form-group">
            <label for="inputPassword3" class="col-sm-2 control-label">
              <span class="red">*</span>
              联系电话
            </label>
            <div class="col-sm-10">
              <input type="text" class="form-control" id="inputPassword3" placeholder="请填写您的手机号">
            </div>
          </div>
          
          <div class="form-group">
            <label for="inputPassword3" class="col-sm-2 control-label">
              <span class="red">*</span>
              需求类型
            </label>
            <div class="col-sm-10">
              <select id="message-demand_type" class="form_select" name="Message[demand_type]" aria-required="true" aria-invalid="true">
                <option value="">请选择需求类型</option>
                <option value="120">企业官网</option>
                <option value="121">门户网站</option>
                <option value="122">电商平台</option>
                <option value="123">o2o平台</option>
                <option value="124">金融平台</option>
                <option value="125">社交平台</option>
                <option value="126">论坛社区</option>
                <option value="127">医疗健康</option>
                <option value="128">视频直播</option>
                <option value="129">其他</option>
              </select>
            </div>
          </div>

          <div class="form-group">
            <label for="inputPassword3" class="col-sm-2 control-label">
              <span class="red">*</span>
              开发类型
            </label>
            <div class="col-sm-10">
              <div class="checkbox">
                <label>
                  <input type="checkbox">网站
                </label>
                <label>
                  <input type="checkbox">APP
                </label>
                <label>
                  <input type="checkbox">微信
                </label>
                <label>
                  <input type="checkbox">其他
                </label>
              </div>
            </div>
          </div>

          <div class="form-group">
            <label for="inputPassword3" class="col-sm-2 control-label">
              备注说明
            </label>
            <div class="col-sm-10">
              <textarea id="message-remark" class="form-control form_textarea" name="Message[remark]" rows="5" placeholder="请填写备注说明"></textarea>
            </div>
          </div>
          
        </form>
      </div>
      <div class="modal-footer text-center">
        <button type="button" class="btn btn-primary" data-dismiss="modal">提交留言</button>
      </div>
    </div>
  </div>
</div>